FEC Form 1 for Keith Ellison Campaign FundForm 1 for Keith Ellison Campaign Fund

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1162899

1. Keith Ellison Campaign Fund

NOTE:Commmittee Name is different than previously reported

P.O. Box 6072
Minneapolis, MN 55406
Email: shellihesselroth@gmail.com;sarah@keithellison.org

2. Date: 05/17/2017

3. FEC Committee ID #: C00630715

This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political
committees/organizations, at least one of which is an authorized committee of a federal candidate.

Committees Participating in Joint Fundraiser

1. Everybody Counts Everybody Matters PAC FEC ID number C00509174
2. Ellison for Congress FEC ID number C00422410

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Shelli Hesselroth
P.O. Box 6072
Minneapolis, MN 55406
Title: Assistant Treasurer

Treasurer:

Carla Kjellberg
P.O. Box 6072
Minneapolis, Minnesota 55406
Title: Treasurer

Designated Agent(s):

Shelli Hesselroth
P.O. Box 6072
Minneapolis, Minnesota 55406
Title: Assistant Treasurer

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1162899

1. Keith Ellison Campaign Fund

NOTE:Commmittee Name is different than previously reported

2. Date: 05/17/2017

This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political
committees/organizations, at least one of which is an authorized committee of a federal candidate.

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Carla Kjellberg
Date Signed: 05/17/2017

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1162899

1. Keith Ellison Campaign Fund

NOTE:Commmittee Name is different than previously reported

2. Date: 05/17/2017

This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political committees/organizations, at least one of which is an authorized committee of a federal candidate.

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Carla Kjellberg Date Signed: 05/17/2017

(End FEC FORM 1)

This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political
committees/organizations, at least one of which is an authorized committee of a federal candidate.

Signed: Carla Kjellberg
Date Signed: 05/17/2017